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The Impact of Demographicson Public Health
Roger Detels, MD, MS
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Demography: The study of
populations, especially withreference to size and density,fertility, mortality, growth, age,
distribution, migration, vitalstatistics and the interaction of
these with social and economicconditions.
Last, JM. A Dictionary of Epidemiology
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World Demographics Profile (1)
Population: 6,928,198,253 (July 2011 est.)
Age structure
0-14 years: 26.3% (male 944,987,919/female 884,268,378)15-64 years:65.9% (male 2,234,860,865/female 2,187,838,153)
65 years and over:7.9% (male 227,164,176/female 289,048,221)(2011 est.)
Median age
Total: 28.4 yearsMale:27.7 years
Female:29 years (2009 est.)
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World Demographics Profile (2)
Population growth rate
1.092% (2011 est.)
Birth rate
19.15 births/1,000 population (2011 est.)
Death rate
8.12 deaths/1,000 population (July 2011 est.)
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World Demographics Profile (3)
Sex ratioAt birth: 1.07 male(s)/female
Under 15 years of age:1.07 male(s)/female15-64 years:1.02 male(s)/female
65 years and over:0.79 male(s)/femaleTotal population:1.01 male(s)/female (2011 est.)
Infant mortality rate
Total: 41.61 deaths/1,000 live birthsMale:43.52 deaths/1,000 live births
Female:39.55 deaths/1,000 live births (2011 est.)
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World Demographics Profile (4)
Life expectancy at birth
Total population: 67.07 yearsMale:65.21 years
Female:69.05 years (2011 est.)
Total fertility rate: 2.46 children born/woman (2011 est.)
Religions
Christian 33.35% (of which Roman Catholic 16.83%, Protestant
6.08%, Orthodox 4.03%, Anglican 1.26%), Muslim 22.43%, Hindu13.78%, Buddhist 7.13%, Sikh 0.36%, Jewish 0.21%, Baha'i0.11%, other religions 11.17%, non-religious 9.42%, atheists
2.04% (2009 est.)
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World Demographics Profile (5)
Languages
Mandarin Chinese 12.44%, Spanish 4.85%, English 4.83%, Arabic3.25%, Hindi 2.68%, Bengali 2.66%, Portuguese 2.62%, Russian
2.12%, Japanese 1.8%, Standard German 1.33%, Javanese
1.25% (2009 est.)
(Percents are for "first language" speakers only; the six UN languages -Arabic, Chinese (Mandarin), English, French, Spanish (Castilian), and
Russian - are the mother tongue or second language of about half of theworld's population, and are the official languages in more than half thestates in the world)
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World Demographics Profile (6)
Literacy (definition: age 15 and over can read and write)Total population, 83.7%; male, 88.3%; female: 79.2%
(Over 2/3rdof the world's 793 million illiterate adults are found inonly eight countries (Bangladesh, China, Egypt, Ethiopia, India,
Indonesia, Nigeria, Pakistan); of all the illiterate adults in theworld, 2/3rdare women)
School life expectancy (primary to tertiary education):
Total,11 years; male, 11 years; female, 11 years (2008)
Education expenditures: 4.4% of GDP (2007)
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World population distribution, 2011
http://www.globalhealthfacts.org/data/topic/map.aspx?ind=79
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World population/age pyramid, 2010 (6,908,689,000 total)
http://populationpyramid.net/?country=World&year=2010
Males Females
http://populationpyramid.net/?country=World&year=2010http://populationpyramid.net/?country=World&year=20108/10/2019 Detels Demographics
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Popu lat ion/Age Pyramid s of the Developed vs Developing Wo rld
http://www.globalchange.umich.edu/globalchange2/current/lectures/human_pop/human_pop.html
http://www.globalchange.umich.edu/globalchange2/current/lectures/human_pop/human_pop.htmlhttp://www.globalchange.umich.edu/globalchange2/current/lectures/human_pop/human_pop.html8/10/2019 Detels Demographics
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Populationpyramids fordeveloping vsdeveloped
countries;projections ofworker per olderadult
Science 333:542-3, 2011
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Percent of population under the age of 15 years, 2010
http://www.globalhealthfacts.org/data/topic/map.aspx?ind=82
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The majority of population growth occurs in developing countries
Science 333:542, 2011
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Total fertility rate (children per woman), 2011
http://www.globalhealthfacts.org/data/topic/map.aspx?ind=87
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Association of education and poverty with fertility
Science 333:541, 2011
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Science 333:541, 2011
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Population growth, historic and projected, and trends in life expectancy
Science 333:540, 2011
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Global Aging
% >60 years old: 10% in 2000
21+% in 2015
Effect of Aging: 60 years:
Health care use 3- to 5-fold greater
50% have two or more chronic conditions
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Proportion of population 60 years or older: world, 1950-2050
http://www.un.org/esa/population/publications/worldageing19502050/pdf/62executivesummary_english.pdf
http://www.un.org/esa/population/publications/worldageing19502050/pdf/62executivesummary_english.pdfhttp://www.un.org/esa/population/publications/worldageing19502050/pdf/62executivesummary_english.pdf8/10/2019 Detels Demographics
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Population in developing vs developed countries
Science 333:543, 2011
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Percent of population living in urban areas, 2010
Urban population: 50.5% of total population (2010)Rate of urbanization:1.85% annual rate of change (2010-15 est.)10 largest urban agglomerations:Tokyo (Japan) - 36,669,000; Delhi (India) - 22,157,000; SaoPaulo (Brazil) - 20,262,000; Mumbai (India) - 20,041,000; Mexico City (Mexico) - 19,460,000; New
York-Newark (US) - 19,425,000; Shanghai (China) - 16,575,000; Kolkata (India) - 15,552,000; Dhaka(Bangladesh) - 14,648,000; Karachi (Pakistan) - 13,125,000 (2009)
http://www.global
healthfacts.org/da
ta/topic/map.aspx
?ind=83
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Rural vs. Urban
Poorer health
Less access to health care
Poorer quality of health care
Higher proportion of elderly, due to industrialization andrequisite migration to urban areas
Slower epidemic potential (population density), but lowerrates of immunity
Higher cost of providing services; e.g., water, electricity, wastedisposal
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http://www.prb.org/pdf09/64.2urbanization.pdf
Percent of Poor Households with Access to Services (continued)
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Impact of Poor Water and
Sanitation
Causes 88% of diarrhea cases; 1.5 million deaths annually
High infant mortality due to dehydration resulting fromdiarrhea
No access to improved water884 million (13% of the
global population)
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http://www.globalhealthfacts.org/data/topic/map.aspx?ind=44
Percentages of population with sustainable access to an improved water
source, 2008
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http://www.globalhealthfacts.org/data/topic/map.aspx?ind=45
Percent of population with access to improved sanitation, 2008
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http://gamapserver.who.int/mapLibrary/Files/Maps/global_cholera_cases_2009.jpg
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Death rate (deaths per 1000 population), 2011
http://www.globalhealthfacts.org/data/topic/map.aspx?ind=90
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Child mortality (deaths under the age of five years per 1000 live births), 2009
http://www.globalhealthfacts.org/data/topic/map.aspx?ind=94
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Maternal mortality (adjusted per 100,000 live births), 2008
http://www.globalhealthfacts.org/data/topic/map.aspx?ind=95
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Female life expectancy at birth (years), 2008
http://www.globalhealthfacts.org/data/topic/map.aspx?ind=97
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Male life expectancy at birth (years), 2008
http://www.globalhealthfacts.org/data/topic/map.aspx?ind=96
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GDP per capita, 2009
http://www.globalhealthfacts.org/data/topic/map.aspx?ind=99
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Percent of population living on less than $1.25/day (varying years of data availability)
http://www.globalhealthfacts.org/data/topic/map.aspx?ind=100
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PovertyGlobally, 1.2 billion (17.4%) of the worlds population live on
20% among Hispanics andAfrican-Americans
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http://www.globalhealthfacts.org/data/topic/map.aspx?ind=48
Prevalence of undernourished (underweight) children (
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Some Conclusions from
Demographic Studies (1)
The majority of the worlds population livesin developing countries
Although fertility is declining, increases in
population will occur primarily in developingcountries in coming decades
Developed countries must cope with a
shrinking productive age population and aburgeoning elderly population
The majority of the global population will
live in urban areas in coming decades
S C l i f
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Some Conclusions from
Demographic Studies (2)
The worlds wealth is concentrated in aminority of countries
Poor sanitation and hunger are
concentrated primarily in countries in sub-Saharan Africa and South Asia
Population density (which promotes
emerging diseases) is greatest indeveloping countries, particularly China andIndia
Gl b l i i i j bl